Despite the Republicans' intention to wreak havoc on the Affordable Care Act (ACA), there's a great neglected opportunity to take a long stride in the opposite direction: adopting state public health-insurance programs. Although the ACA survives, it was damaged by the December repeal of the individual mandate, which required that all Americans have health insurance. As a result, 13 million Americans may lose their insurance, according to the Congressional Budget Office. We could start reversing that trend through state action.
Last year, Bernie Sanders called for public option health insurance “in every state in this country.” Given political realities, that is not in the cards. But current conditions do favor getting a public option now for a big chunk of the population. There are eight states that have Democratic control of both the legislature and the Governor's office. Over 20 percent of Americans live in those states, about 65 million people. Any of those states could enact a public health-insurance option in 2018 or 2019. If just one state did so, it would open the door for other states to follow, creating the foundation for further expansion of health coverage in the years to come.
